james lind and citrus against scurvy

In this blog we will tell the story of James Lind, a Scottish doctor from the 18th century who carried out the first controlled clinical trial with which he was able to determine the importance of consuming citrus fruits for the treatment of the disease known as scurvy.

But what is scurvy?

It turns out that the human body is always in a state of balance between hundreds of substances including vitamins, minerals, proteins, carbohydrates, and lipids. These are the ones that allow the body to function and diseases can appear when there is an excess or deficit of one. 

In the case of scurvy, the missing vitamin is the C, also known as ascorbic acid, and it happens that this vitamin is found in all kinds of citrus fruits, including oranges, tangerines and lemons. at the 18th century there was not the slightest bit of knowledge that they were vitamins and even less about what produced scurvy.

Was scurvy very serious at that time?

To answer this you have to take into account the context of the time. The kingdom of Great Britain was in conflict with other kingdoms, taking place a great battle at sea level. With this in mind, some historians report that more deaths occurred from diseases such as scurvy than from the battles themselves, so much that on the voyage of the ship Anson of the 1900 sailors who set sail, only 500 reached the end of their voyage because of the scurvy.

And who was James Lind?

Well, James Lind was a physician born on October 5, 1716 in Edinburgh, Scotland. As was frequent at that time, he began his medical studies as an assistant to a surgeon in 1731 and 8 years later in 1739 he entered as a naval doctor for the army of the Kingdom of Great Britain.

What was the relationship between James Lind and scurvy?

It was in 1747 when Lind was on the Slisbury ship and had already added more than 10 years of service as a naval doctor that several cases of scurvy appeared on his ship, so after much thought he decided to do something that we know today as a controlled clinical study.

It happened that when they had already completed 2 months of maritime voyage, some of the sailors became ill with scurvy, seeing this opportunity and trying to avoid selection biases, he separated 12 sick sailors who presented similar characteristics such as receiving the same diet and being in the same stage of disease, to which he administer the 6 most frequent treatments for scurvy of that time, seeking to find a difference in the evolution of the disease between the different groups.

These treatments consisted of a quarter of cider, drops of sulfuric acid (known as vitriolic elixir), 2 oranges and 1 lemon, vinegar, half a pint of seawater and finally a purgative. After some time, the patients treated with oranges and lemons presented noticeable improvement.

Given this fact, he proposed citrus fruits as a possible solution for scurvy, without being very clear about what it was that made sailors improve and much less that the deficiency of vitamin C was the cause of scurvy.

Was James Lind the first to see the citrus scurvy relationship?

The answer is no. For the particular case of scurvy, someone named John Woodall in the 17th century had already referred to the relationship between the consumption of citrus fruits and the improvement of scurvy, however, this finding was not accepted by the population, so it was forgotten.

Why is James Lind remembered for finding the relationship between scurvy and citrus fruits and not John Woodall?

James Lind is recognized more for devising a way to make his discovery known through a controlled clinical experiment than for being the first to think of this relationship. And it is because of the above, as we have said in other blogs, that not only the discovery per se is important, but the way to make it known in such a way that it is irrefutable or at least that it can be repeated in the population.

¿Hizo algún otro aporte James Lind?

Resulta que él creía que las enfermedades también se producían por falta de una higiene adecuada lo que lo llevó a dar recomendaciones sobre el aseo de los barcos, el cambio de cama, fumigación con arsénico y el uso de agua destilada para el consumo humano. De hecho su tesis para medicina fue de enfermedades venéreas. También hizo un tratado de enfermedades tropicales.

What can we conclude from the story

James Lind was a Scottish doctor who, through the first controlled clinical trial, was able to reliably demonstrate the usefulness of citrus fruits in the treatment of scurvy. He was not the first to discover the relationship between citrus fruits and scurvy, but he was the first to demonstrate it in an irrefutable way. Therefore we emphasize again the importance of publishing the discoveries in the appropriate way so that they do not fall into oblivion.

However, despite its discovery, it was not until almost 50 years after the British Navy began to use citrus fruits as a means of preventing scurvy, so another conclusion would be that all discoveries always take time to be approved by both the scientific community and the population. 

To finish, don’t forget to eat one fruit a day.

Bibliografía

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